Pap Test Warning in Ad Campaign May Mislead

From CDC National Prevention Information Network

November 11, 2005

In ads on TV and in magazines, Digene Corp. is promoting its test for human papillomavirus (HPV). The ads suggest that a Pap test alone might be insufficient for detecting cervical cancer. However, some doctors say the ads are somewhat misleading.

The HPV test can only be administered with a Pap test, because the Pap test supplies the cell sample from which DNA is extracted to look for HPV. A patient's doctor may already be administering the HPV test if he or she is not using the older version of the Pap test.

According to Dr. Abbie Roth, an obstetrician-gynecologist at Northwestern Memorial Hospital, most gynecologists today use the newer liquid-based Pap test that would not require obtaining a second cell sample for an HPV test. The lab will "reflexively" test for HPV if a specific abnormality turns up in the Pap test, Roth said. Otherwise, a physician must request an HPV test. Roth said many insurance plans do not cover STD testing. The out-of-pocket cost for the HPV test averages $50-$200. Economic studies have shown that using HPV and Pap tests together costs less than Pap tests alone because fewer additional procedures are needed later.

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Roth reminded that cervical cancer can develop without HPV infection and noted other risk factors, including smoking, early sexual activity, multiple partners and a partner with multiple partners. Roth said many of her patients are now requesting the test. She added, however, that she wishes the ads had defined HPV as an STD; this, she said, would help doctors initiate discussions of the patient's sexual history.

Pam Rasmussen, Digene's vice president for corporate communications, said, "We need to get the word out that you increase your protection 100 percent if you have the HPV test at the same time [as the Pap test]."

Four years after its 1999 approval of the HPV test for women with borderline abnormal Pap results, the Food and Drug Administration authorized its use as an adjunct to Pap tests for women age 30 and older.

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